KELLY STARK

IDAHO FALLS, ID
NPI1114343985
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: ID  LMSW -33495)
Enumeration Date2014-03-17
Last Update Date2014-03-17
Business Address
-- KELLY STARK
3422 S 15TH E
IDAHO FALLS, ID 83404-8262
Phone number: 208-552-1222
Mailing Address
-- KELLY STARK
3422 S 15TH E
IDAHO FALLS, ID 83404-8262
Phone number: 208-552-1222
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